Bidirectional relationships of comorbidity with obstructive sleep apnoea

Area of Science:

• Sleep Medicine
• Cardiology
• Nephrology
• Endocrinology

Background:

• Obstructive sleep apnoea (OSA) is linked to numerous comorbidities, including metabolic, cardiovascular, renal, pulmonary, and neuropsychiatric conditions.
• While OSA is a known risk factor for these conditions, emerging evidence suggests some comorbidities may also predispose individuals to developing OSA.

Purpose of the Study:

• To review the evidence for bidirectional relationships between OSA and its comorbidities.
• To focus on comorbidities that may predispose individuals to OSA.
• To examine the impact of therapy on these bidirectional relationships.

Main Methods:

• Literature review of existing evidence on OSA and comorbidity interactions.
• Analysis of proposed mechanisms underlying bidirectional relationships.
• Evaluation of therapeutic implications.

Main Results:

• Strong evidence supports bidirectional relationships between OSA and heart failure, metabolic syndrome, and stroke.
• Mechanisms vary, with fluid retention important in heart failure and renal disease, and neural factors in diabetes and stroke.
• Hypertension and atrial fibrillation appear more as consequences of OSA, with limited evidence for bidirectionality.

Conclusions:

• The relationship between OSA and comorbidities is complex and often bidirectional, necessitating accurate diagnosis for optimal management.
• Identifying OSA in patients with conditions like COPD is critical for effective therapeutic strategies.
• Further research into the specific mechanisms and therapeutic impacts of these bidirectional relationships is warranted.